Form Complaint-001 - Complaint Form - Arizona Department Of Financial Institutions


Arizona Department of Financial Institutions
Complaint Form
Instructions & Check List
Section 1
Page 1
Before you file a complaint, you should contact the company and express your concern or dissatisfaction. You
may be able to come to a resolution without filing a complaint. When you call the company, ask to speak to someone in
authority, be courteous and remain calm. Explain the problem and provide dates and amounts paid or billed, have important
documents, and present as many facts as possible. Explain what type of remedy you are seeking. If this fails to resolve your
complaint, you may wish to complete the complaint form at the end of this page.
Upon filing a complaint, the information will be entered into the Department’s database, assigned a number and assigned to a
Consumer Affair’s examiner. The examiner will send you a confirmation letter with his/her contact information. The Consumer
Affairs Division can only act on violations of laws, rules and regulations on entities regulated by the Department. The Consumer
Affairs Division cannot give you legal advice nor can they recommend an attorney to you. Except in limited circumstances, the
Consumer Affairs Division cannot pursue legal redress on your behalf. You should always contact a private attorney who can
advise you of your rights. The Consumer Affairs Division will not interfere with pending litigation if an attorney has been
retained, nor will the Division act on behalf of either party to the dispute. The Consumer Affairs Division cannot investigate a
verbal complaint. All Complaints must be in writing.
Type directly on the complaint form below and save it to your computer or print the form out and fill it in manually.
Please be aware that you cannot file a complaint on behalf of someone else.
A copy of this complaint will be provided to the person or company you are complaining against.
Explain the problem in detail; include all important information, such as dates, places, contracts, letters,
advertisements, sales slips or other documents that may support your complaint. Attach an additional sheet to
explain the problem, if necessary. Keep all original supporting documents for your files.
Please complete the complaint form and return it to our office. Our ability to assist you will depend upon your giving
us a complete and detailed statement including any misrepresentation made to you.
Please provide a valid e-mail address to expedite the processing of your complaint.
Check List:
- Review
look-up a licensee
to make sure the financial institution or enterprise is licensed with AZDFI.
- Read the
Q&A for filing a complaint
and the
Other Regulator Referral List.
- Complete the complaint form below.
- If you are sending the complaint through U.S. Mail, please submit the original complaint form and a copy of the
all supporting documents. Keep a copy of the complaint form for your records. Keep all original supporting
- If you are sending the complaint through e-mail, save the completed form and e-mail it to
along with your supporting documentation.
- If you have confidential information, you may submit your complaint by e-mail through AZDFI confidential e-mail
(Zix Mail). All you need is an e-mail address, passcode and follow these
to create a secured e-mail
account and submit your complaint. You do not need to fill out the Electronic Submission Form, but you must choose
the “Financial Services” drop down when you send in your complaint.
- If you are sending the complaint through facsimile, save the completed complaint form and fax it to 602-381-
1225, attention: Consumer Affairs Division, along with your supporting documentation.
Telephone: (602) 771-2800
FAX: (602) 381-1225
See our website at
2910 North 44
Street, Suite 310
Phoenix, AZ 85018


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Parent category: Financial